Intravenous Tranexamic Acid Reduces Postoperative Blood Loss After High Tibial Osteotomy

Palanisamy, Jeya Venkatesh; Das, Saubhik; Moon, Kyung Ho; Kim, Doo Hyun; Kim, Tae Kyun

doi:10.1097/corr.0000000000000378

Cited by 37 publications

(87 citation statements)

References 20 publications

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“…It has achieved good results in TKA and total hip arthroplasty (THA). However, few studies have been conducted on the role of TXA in HTO, and most of the research has only concentrated on the effects of intravenous or topical application alone on blood loss. The aim of the present study was to explore the efficacy and safety of the combined administration of TXA after HTO.…”

Section: Discussionmentioning

confidence: 99%

“…The results showed that the decrease in the drainage volume and hemoglobin 1 day after the operation in the TXA group was lower than that in the solo group, and the difference was statistically significant ( P < 0.05). Through a retrospective study of 66 HTO patients, Palanisamy et al found that intravenous administration 10 minutes before application of the tourniquet and intravenous administration of TXA 3 h after the operation could reduce blood loss. In another retrospective study, Kim et al injected TXA at a dose of 10 mg/kg before and 6 h after tourniquet application and 24 h after the operation.…”

Section: Discussionmentioning

confidence: 99%

“…It can reduce the perioperative loss of blood and the transfusion rate, while it does not increase the risk of complications such as deep venous thrombosis (DVT). However, its application in HTO has been rarely studied. TXA has many methods of administration, including intravenous, intramuscular, topical and oral administration; among these methods, intravenous and topical administration, are commonly used in orthopaedics.…”

Section: Introductionmentioning

confidence: 99%

“…No thrombosis was found in postoperative routine CT angiography of lower extremities, and no thrombosis‐related symptoms were found in any patients. Palanisamy et al also conducted a retrospective study on the effect of intravenous TXA in HTO, but TXA was used 10 min before the use of a tourniquet and 3 h after the operation. Palanisamy et al suggest that TXA can reduce blood loss in patients after HTO, but no blood transfusion occurred even without TXA.…”

Section: Introductionmentioning

confidence: 99%

“…Palanisamy et al suggest that TXA can reduce blood loss in patients after HTO, but no blood transfusion occurred even without TXA. Moreover, due to the limitations of the sample size and follow‐up time, Palanisamy believes that the value of TXA in the prevention of incisional complications and DVT is uncertain. Therefore, TXA is not recommended in the perioperative period of HTO.…”

Section: Introductionmentioning

confidence: 99%

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Intravenous Combined with Topical Tranexamic Acid Administration Has No Additional Benefits Compared with Intravenous Administration Alone in High Tibial Osteotomy: A Retrospective Case‐Control Study

Guo

et al. 2020

Orthopaedic Surgery

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Objective: To investigate whether intravenous combined with topical administration of tranexamic acid (TXA) is superior to intravenous administration alone in terms of blood loss, incision complications, functional recovery, and pain relief in high tibial osteotomy (HTO). Methods:Clinical data of patients with knee osteoarthritis (OA) treated with unilateral HTO were retrospectively reviewed. The patients were grouped according to the TXA administration method, with 24 patients in the combined group and 21 in the solo group. In the combined group, 100 mL saline containing 1 g TXA was intravenously administered before application of a tourniquet, and 20 mL saline containing 2 g TXA was injected through a drainage tube after closure of the incision. Alternatively, 100 mL of saline containing 1 g TXA was intravenously administered before application of a tourniquet in the solo group. The blood loss and adverse events were compared between the two groups.Results: All patients were followed for more than half a year. The drainage volume on the first day and total blood loss on the second day after surgery in the combined and single treatment groups were 130.06 AE 29.22 and 165.35 AE 43.08 mL (P < 0.05), respectively, and 327.17 AE 64.26 and 385.45 AE 63.31 mL (P < 0.05). There were no blood transfusions in either group. One case of delayed incision healing was observed in the solo group, and no such event occurred in the combined group. There were no significant differences between the two groups in terms of the following factors: the activated partial thromboplastin time (APTT) and prothrombin time (PT); levels of fibrinogen (FIB) and D-dimer on the second day after surgery; numbers of hospitalization days and thromboembolism events; and knee joint function and visual analog score 6 months after surgery.Conclusion: Intravenous combined with topical TXA administration in HTO is superior to intravenous administration alone for reducing postoperative blood loss and drainage volume without thromboembolic complications. However, even with only intravenous TXA administration, no cases of blood transfusion and only 1 case of incision complication occurred. At the same time, the combined use of TXA did not improve the recovery of knee joint function and pain relief after HTO.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Intravenous Combined with Topical Tranexamic Acid Administration Has No Additional Benefits Compared with Intravenous Administration Alone in High Tibial Osteotomy: A Retrospective Case‐Control Study

Guo

et al. 2020

Orthopaedic Surgery

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Unicompartmental Knee Osteoarthritis: Alignment Osteotomies

Encinas-Ullán

Gómez-Cardero

Rodríguez-Merchán

2020

Comprehensive Treatment of Knee Osteoarthritis

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The use of tranexamic acid reduces blood loss in osteotomy at knee level: a systematic review

Bierke

Häner

Bentzin

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Aim of this systematic review was to evaluate the literature regarding the efect of tranexamic acid (TXA) on the outcome after knee osteotomy. Methods A systematic literature search was carried out in various databases on studies on the use of tranexamic acid in osteotomies around the knee. Primary outcome criterion was the hemoglobin (drop). Secondary outcome criteria were total blood loss, drainage volume, adverse efects such as thromboembolic events, blood transfusions, wound complications and clinical scores. A meta-analysis was performed for quantitative measures. The present study was registered prospectively (www. crd. york. ac. uk/ PROSP ERO; no.: CRD42021229624). Results Seven studies with 584 patients (TXA group: 282 patients, non TXA group: 302 patients) Hemoglobin decrease (1.54 g/dl vs. 2.28 g/dl), blood loss (394.49 ml vs. 595.54 ml) and drainage volume (266.5 ml vs. 359.05 ml) were signiicantly less in the TXA group compared to the non TXA group. No thromboembolic event was noted in any study. In the non TXA group four blood transfusions were given. Eleven wound complications occurred in the non TXA group in comparison to two wound complications in the TXA group. ConclusionsThe results of the present study show that the application of TXA reduces hemoglobin drop, blood loss and drainage volume. These efects could be responsible for the lesser rate of side efects after administration of TXA during knee osteotomy. KeywordsHigh tibial osteotomy • Medial open wedge osteotomy • Distal femoral osteotomy • HTO • DFO • Osteotomy and tranexamic acid * Wolf Petersen

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Intravenous Tranexamic Acid Reduces Postoperative Blood Loss After High Tibial Osteotomy

Abstract: Level III, therapeutic study.

Cited by 37 publications

References 20 publications

Intravenous Combined with Topical Tranexamic Acid Administration Has No Additional Benefits Compared with Intravenous Administration Alone in High Tibial Osteotomy: A Retrospective Case‐Control Study

Intravenous Combined with Topical Tranexamic Acid Administration Has No Additional Benefits Compared with Intravenous Administration Alone in High Tibial Osteotomy: A Retrospective Case‐Control Study

Unicompartmental Knee Osteoarthritis: Alignment Osteotomies

The use of tranexamic acid reduces blood loss in osteotomy at knee level: a systematic review

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